Ekg help!!!

[BaylorEMT]

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What do you see in the EKG? I see LBBB and LVH but I have others saying different. Help please 😱

 

[turkeyjerky]

So, first of all, you can't call LVH when you have LBBB. As for the ECG, it's a RBBB.

 

[VisionaryTics]

So, first of all, you can't call LVH when you have LBBB. As for the ECG, it's a RBBB.

Yep. Split positive R wave in V1 means terminal ventricular contraction is delayed and to the right.

 

[BaylorEMT]

Thanks guys!

 

[turkeyjerky]

Yep. Split positive R wave in V1 means terminal ventricular contraction is delayed and to the right.

I wouldn't even worry about that--people make way too big a deal about bunny ears. Look for the slurred S waves in I and V6, and if the QRS is positive in V1->RBBB. One doc I worked with just said if V1 is positive, then it's a right bundle, if negative it's a left bundle. That's a bit too simplistic for me, and you run the risk of missing an interventricular conduction delay (an indicator of hyperkalemia).